Pathologic Gait Flashcards
What are potential causes of altered gait?
Pain
Past injury - spinal learning and reeducation of motor patterns
Peripheral sensory loss
LMNL (loss of tone with weakness)
UMNL (increased tone with weakness)
What is the cause of a Trendelenberg gait?
Weak gluteus medius or lateral hip stabilizer
What does a Trendelenberg gait look like?
Hip translates laterally while weight bearing on the involved side
What peripheral nerve is likely affected in a patient with Trendelenberg gait?
Superior gluteal nerve
What nerve root is likely affected in a patient with Trendelenberg gait?
L5
What muscles are likely affected in a patient with Trendelenberg gait?
Gluteus medius or lateral hip stabilizers
What does a gluteus medius lurch look like?
Torso leans laterally over the affected hip when weight bearing with significant pain and paralysis of the gluteus medius or lateral hip stabilizers
What muscles are affected in a patient with a gluteus medius lurch?
Gluteus medius or lateral hip stabilizers
What peripheral nerve is likely affected in a patient with a gluteus medius lurch?
Superior gluteal nerve
What nerve root is likely affected in a patient with a gluteus medius lurch?
L5
What does a gluteus maximus lurch look like?
Lack of leg extension during gait with the torso extending and rotating ipsilaterally while weight bearing on the involved side
What peripheral nerve is likely affected in a patient with a gluteus maximus lurch?
Inferior gluteal nerve
What nerve root is likely affected in a patient with a gluteus maximus lurch?
S1
What are potential causes of a circumduction gait?
Knee fusion, weak quadriceps, spastic paresis (UMNL)
What muscle is likely weak in a patient with a circumduction gait?
Quadriceps
What peripheral nerve is likely affected in a patient with a circumduction gait?
Femoral nerve
What nerve root is likely affected in a patient with a circumduction gait?
L4
What does a circumduction gait look like?
Knee remains fixed in extension while hip ABucts/Circumducts to move involved leg forward
What does a hip hike gait look like?
QL contracts to lift the foot from the floor allowing for gait flexion while leg moves within the sagittal plane
What can cause a hip hike gait?
- knee fusion
- L4 Nerve root
- femoral nerve
What muscle is likely weak in a patient with a hip hike gait?
Quadriceps
What peripheral nerve is likely weakened in a hip hike gait?
Inferior gluteal nerve
What nerve root is likely weakened in a hip hike gait?
S1
What does a slappage gait look like?
Foot slaps the floor immediately following heel strike
What are potential causes of a slappage gait?
Mild-moderate weakness of ankle dorsiflexors due to a possible strain
Possible sensory loss from a dorsal column lesion
What type of gait can be caused by a dorsal column lesion?
Slappage gait
What peripheral nerves are likely affected in a slappage gait?
Superficial peroneal nerve or deep peroneal nerve
What nerve roots are likely affected in a slappage gait?
L4-L5
What muscle group is likely weak in a patient with a slappage gait?
Ankle dorsiflexors
What does a steppage gait look like?
Increased knee flexion clears foot from the floor with the toe placed down first and then the heel follows with tripping over involved foot
What are causes of a steppage gait?
Weakness or paralysis of ankle dorsiflexors
What muscles are likely weak in a steppage gait?
Ankle dorsiflexors
What peripheral nerves are likely affected in a patient with a steppage gait?
Superficial peroneal nerve or deep peroneal nerve
What nerve roots are likely affected in a patient with a steppage gait?
L4-L5
What gait can be associated with Charcot Marie tooth disease?
Slappage gait
If a patient has ankylosing spondylitis of the knee what gaits may be present?
Circumduction or hip hike
